Post-Traumatic Corneal Ulcer with Hypopyon and Secondary Anterior Uveitis in an Uncontrolled Diabetic

Doi: 10.36351/pjo.v42i2.2256

Abstract

Corneal ulcer is a serious eye condition that can be complicated by secondary anterior uveitis, especially in patients with systemic comorbidities. A 56-year-old female with uncontrolled diabetes mellitus presented with a central corneal ulcer, stromal infiltrates, 360° neovascularization, corneal edema, and hypopyon filling half of the anterior chamber. Microscopy revealed Gram-positive bacilli with polymorphonuclear cells, indicating the presence of Bacillus cereus, though bacterial and fungal cultures were negative. The patient received intensive topical and systemic antimicrobials, but was subjected to hypopyon aspiration, intracameral antimicrobial injection, and amniotic membrane transplantation (AMT) with a bandage contact lens due to persistent hypopyon. Postoperatively, ocular surface stabilization and symptom relief were achieved, but the final visual acuity remained limited to light perception. This case highlights the importance of early suspicion of harmful organisms in post-traumatic keratitis, outlining the role of combined medical and surgical methods, including AMT, in preserving globe integrity.